Embarrassing Illnesses

The aim of treating threadworms is to get rid of the parasites and prevent re-infection.

To successfully treat threadworms, the entire household must be treated, even if not everyone has symptoms.

You can either:

• follow a strict hygiene method (as outlined below) for six weeks, or
• take medication and follow a strict hygiene method for two weeks.

Some medications may be available from your local pharmacy without prescription. You should always follow the manufacturer's instructions because these types of medications may not be suitable for everyone. You should see your GP if you have threadworms and:

• you are pregnant,
• you are breastfeeding, or
• you have a baby under three months old.

Hygiene method

Strict hygiene measures can be used to clear up a threadworm infection and reduce the likelihood of re-infection. As the life span of the threadworms is approximately six weeks, it is important that these hygiene methods are followed for this period. Make sure that everyone in the household is following this advice.

• Wash all sleepwear, bed linen, towels, and cuddly toys when first diagnosed - this can be done at normal temperatures but make sure that the washing is well rinsed.
• Thoroughly vacuum and dust the whole house, paying particular attention to the bedrooms. Continue to vacuum regularly and thoroughly.
• Carefully clean the bathroom and kitchen by 'damp-dusting' surfaces, and washing the cloth frequently in hot water. Continue to clean bathroom and kitchen surfaces regularly and thoroughly.
• Avoid shaking any material that may have eggs on it, such as clothing, or bed sheets, as this may transfer the eggs to other surfaces.
• Do not eat food in the bedroom because you may end up swallowing eggs that have been shaken off the bedclothes.
• Keep your finger nails short.
• Discourage nail biting and finger sucking - in particular, make sure that children do not suck their thumb.
• Wash your hands frequently, and scrub under your finger nails, particularly before eating, after visiting the toilet, and before and after changing a nappy.
• Wear close-fitting underwear at night and change your underwear every morning.
• Wearing cotton gloves at night may help to prevent scratching while you are asleep.
• Bath, or shower, regularly, particularly first thing in the morning, and make sure that you clean around your anus and vagina to remove any eggs.
• Ensure that everyone in your household has their own face flannel and towel. Avoid using communal (shared) towels.
• Keep toothbrushes in a closed cupboard and rinse them thoroughly before use.

Even after the infestation has cleared up, you should continue with good general hygiene measures, such as washing you hands after going to the toilet. Children can easily pick up another threadworm infection from friends or at school, and good hygiene may help prevent another outbreak.

Medication

Medication can also be used to treat threadworms. It should be taken by everyone in the household. The high risk of transmission (around 75 per cent between family members) means that everyone is likely to be infected, even if they do not have any symptoms.

See the information below if you are pregnant, breastfeeding, or you have a baby who is under three months old, as medication is not recommended.

The most common medications that are used to treat threadworm infections are:

• mebendazole, and
• piperazine.

Mebendazole

Mebendazole prevents the threadworms from being able to absorb glucose, which means that they will die within a few days.

Mebendazole is the preferred treatment option for anyone who is over two years of age. It can be taken in chewable tablet form or as a teaspoon of liquid to be swallowed. One 100mg dose is usually enough but, if re-infection does occur, a repeated dose can be prescribed.
 
Very rarely, mebendazole can cause abdominal pain or diarrhoea, particularly if the infection of threadworms is very severe.

Piperazine

Piperazine paralyses the threadworms until they are pushed naturally out of the bowel. It is sometimes combined with a medication called senna. Senna has a slight laxative effect (helps you empty your bowels) which helps expel the worms quicker. Piperazine and senna usually come in a sachet of powder, which you mix with a small amount of milk or water before drinking.

Piperazine can be used to treat children who are between three months to two years of age, but it needs to be taken in two doses (either 2.5ml or 5ml each), two weeks apart. Piperazine is not recommended if you have epilepsy (a condition that causes seizures) or problems with your liver or kidneys.

Mebendazole and piperazine are between 90-100 per cent effective at killing the threadworms, but they cannot kill the eggs. Strict hygiene measures should still be followed for two weeks after treatment (see above).

You should see your GP if the infection persists after using medication. They may recommend that you begin a second course of medication.

Pregnancy and breastfeeding

Medication for threadworm is not usually recommended during pregnancy or while breastfeeding. The hygiene method is the preferred method for treating a threadworm infection.

Mebendazole, or piperazine, should never be taken during the first trimester of pregnancy (up to week 13). During the second, or third, trimester (weeks 14-26, and week 27 onwards), and during breastfeeding, medication can be used if necessary. You should see you GP, who may prescribe mebendazole.

Babies under three months of age

Medication is not advised for babies who are under three months of age. Instead, you should follow the hygiene method. Make sure that you wash the baby's bottom gently, but thoroughly, every time that you change their nappy. Also, ensure that you wash your hands before and after changing their nappy.